Arthrodesis of the ankle: a critical analysis.
Arthrodeses of 81 ankles performed by a single surgeon were reviewed after a 12- to 74-month follow up. Average time to union was 13.8 weeks, and 71 (88%) of 81 ankles healed without a second surgery. Ten (12%) of the 81 ankles failed to unite. Of the 10 nonunions, two developed a dense fibrous union without screw failure, and eight underwent revisional surgery. Seven of the revisions united and one has a persistent nonunion. The transfibular approach was utilized, and specific factors related to this approach were assessed. A greater resection of the medial malleolus correlated to a longer healing time and to an increased rate of nonunion. Sixty (96%) of the 63 patients who returned for follow up had no signs or symptoms attributable to malalignment. The average postoperative score for ankle-hindfoot on the AOFAS evaluation was 74 points, and rate of the patient satisfaction was 65 (89%) of the 73 patients. There was no correlation between outcomes and patients ages. Greater tarsal mobility correlated with a higher postoperative score and to higher level of satisfaction.
Mann
R A
RA
Foot Fellowship Program, Oakland, California 94609, USA.
Rongstad
K M
KM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000843:Ankle Joint / Q000503:physiopathology / Q000601:surgery*; D001174:Arthrodesis / Q000009:adverse effects / Q000379:methods*; D001863:Bone Screws; D005260:Female; D006801:Humans; D007592:Joint Diseases / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009068:Movement; D010146:Pain / Q000209:etiology; D012189:Retrospective Studies; D016896:Treatment Outcome